辨治慢性肝病的临证经验

Clinical Experience in Treating Chronic Liver Diseases

辨证施治是中医临床的根本,治疗慢性肝病,应辨证结合辨病。对证型重叠交杂者应分清主次;当无证可辨时,应遵循“有证辨证、无证辨病”的原则。肝病的发生和演变十分复杂,要考虑“病”和“期”的动态变化;对于临证用药,主张一法为主,多法联用;同时治肝不忘和胃、益肾,时时注意顾护脾胃;对病情复杂者,要善处治疗矛盾,灵活掌握药味和比重,做到“正邪兼顾,分清主次”。

Treatment based on syndrome differentiation is the base of traditional Chinese medical practice, but syndrome differentiation also should be combined with diagnosis of diseases in the treatment of chronic liver diseases. When the types of syndrome overlaps, the chief or secondary aspect should be distinguished; if there is no symptom and sign, the principle of differentiation of diseases should be followed; if the development of the disease is very complicated, dynamic changes of ＂disease＂ and ＂stage＂ should be considered; ＂one main therapeutic method accompanied with various therapeutic methods＂ is advocated; regulating the stomach, invigorating the kidney and protecting the spleen and the stomach should not be forgoton when treating liver desease; if the pathogenetic condition is complicated, contradiction should be well dealt with, ingredients and proportion of drugs should be used nimbly; ＂giving consideration to both vital and pathogenic factors, distinguishing chief and secondary aspects＂ should be grasped.